Patients often ask how drugs are selected by the FDA for use in different diseases. Below is a brief review of the process that is used to evaluate and test drugs that may benefit patients. Before a drug can be approved for use by patients, there is a set of clinical tests that must be performed. This is the Pre-Clinical Research Stage, where extensive animal tests are performed on dosing and side effects. Institutional and [...]
As readers of this blog are probably aware, the prevailing theory of AD is that amyloid precursor protein is somehow aberrantly cleaved as it is secreted by neurons, and leads to the formation of beta-amyloid. Beta amyloid is a toxic “oligomer” or protein fragment that becomes improperly folded, and deposits into plaques. It is believed that the small oligomers of beta amyloid are more toxic than their larger aggregated counterparts (i.e.,amyloid fibrils), and in fact, [...]
Building on their previous discovery that people with Alzheimer’s have beta-amyloid deposits that appear as unusual cataracts in the lens of the eye, a team of researchers led by Dr. Lee Goldstein at Boston University School of Medicine, has discovered that beta-amyloid also accumulates in the eyes of people with Down syndrome. Down syndrome patients develop symptoms of Alzheimer’s Disease often by the age of 30 because they have an extra copy of a key [...]
Readers, A relationship between vascular risk factors and Alzheimer disease has been considered for over 20 years. In fact, it was widely accepted that “a hardening of the arteries” was to blame for senile dementias. There is also evidence that vascular diseases such as stroke, atherosclerosis, and hypertension are associated with an increased risk of dementia and AD, and that an abnormally elevated level of fibrinogen, the protein critical for blood clot formation, is correlated [...]
Increasing evidence indicates that there are reductions in testosterone and estrogen levels in older men and women. These hormonal reductions may be risk factors for cognitive impairment and the development of Alzheimer’s disease (AD). As testosterone levels decline as men age, there is an urge to treat this natural process with hormone replacement, just as it is done for many women undergoing menopause. The enzyme aromatase in the male brain converts some of the testosterone [...]
Readers, The Alzheimer’s Disease Neuroimaging Initiative (ADNI) continues to provide us with greater and more detailed information about AD. For quite some time, we have known that the ApoE4 genotype leads to an increased risk of developing sporadic AD. Patients with the ApoE4 gene (carriers) typically develop Alzheimer’s disease five to seven years earlier than those without the gene (non-carriers). One or more copies of the ApoE4 gene are present in 20 percent to 30 percent of the [...]
Readers, Two of the key elements when taking a history from a patient include smoking tobacco and alcohol consumption. Both of these activities have been shown to affect general health. Now, in a recently published study from Barcelona, Spain, it appears that they may be important risk factors in Alzheimer’s disease (AD), but in a unique way. Knowledge regarding environmental factors influencing the risk of AD is surprisingly scarce, despite substantial research in this area. [...]
Readers, I wanted to share with you an update on the cost estimates of AD. These are, of course, in addition to the incalculable emotional losses caused by the disease, but are quite astonishing in themselves. The tremendous physical and emotional cost of the disease to Alzheimer’s sufferers and their families has been known for decades. There is also, however, a financial cost of the disease. Finally, in 1998 and again in 2002, reports were [...]
Readers, Rarely a day goes by when we do not see several news items about the role of neuro-imaging in detecting, treating or monitoring the progression of Alzheimer’s disease. Here are a few comments to bear in mind as you consume the daily press. Magnetic Resonance Imaging (MRI) yields an image of brain structure and will reveal tumors, strokes and (importantly for Alzheimer’s disease) atrophy (or shrinkage) in particular parts of the brain that can [...]
Based on current evidence, the recent conclusion reached by a National Institute of Health panel of experts, is statistically sound. They concluded that we do not yet have proof that the progression of Alzheimer’s disease pathology can be slowed by actively reducing known risk factors and by adopting certain lifestyle changes such as smoking cessation, intellectual stimulation, and physical exercise. This is a case where I think it is worthwhile to translate the panel’s conclusion. [...]
